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Warring on multiple fronts

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The bidding war for a slice of Fortis Healthcare continues, as the reconstituted board’s request for fresh bids had four suitors stepping forward. The good news is that the process now seems to be more transparent, with bidders allowed 10 days for due diligence with access to the data room. The new round of bidding has safeguards for the shareholders too, as it specifies certain minimum conditions, ensuring a more fair comparison between bids. For one, all binding offers should offer a minimum infusion of ₹ 1500 crore via a preferential allotment. Secondly, the bids should lay out a plan to fund the acquisition of Religare Health Trust (RHT) assets. Thirdly, the binding offers should make provision for the exit of private equity investors in SRL, as well as details of a retention plan of the current management and employees.

It is interesting that Manipal Hospitals, one of the three bidders for Fortis, as well as its prime rival for the numero uno position, Apollo Hospitals, are two of the bidders for yet another failing healthcare entity, the Seven Hills Hospitals. Struggling with debts of ₹ 1300 crore, Seven Hills Hospitals has been part of insolvency proceedings initiated by the National Company Law Tribunal (NCLT) last year. The consortia of lenders, led by Axis Bank and State Bank of India, have reportedly sold 77 per cent of this debt to Bank of America, Merrill Lynch and JM Financial Asset Reconstruction Company. This puts the latter in the driver’s seat with majority stakes in the two-hospital group which collectively has 1000 beds. The news must be disappointing for pure play hospital bidders. Media reports mention that Aster DM and Narayan Health, in partnership with the Piramal Group, were other groups which had shown interest in Seven Hills Hospitals.

As the tussle for supremacy in India’s private hospital space plays out, the country’s health system is gearing up for a fight on another front: the Nipah virus. With the death toll already at 13 and counting, the detection, containment and treatment of Nipah virus cases is crucial to prevent further infection, especially as there is no vaccine as yet. There are lessons to be learnt from the Nipah virus episode.

Firstly, to ensure healthcare workers use the right procedures and protection gear to protect them from infections. Carelessness of healthcare staff as well as cutting corners on sanitation equipment and processes by hospital managements will cost more lives, especially in a world that is more connected than the world our parents live in. With overseas travel becoming more affordable, Indian tourists could be bringing back much more than duty free goods and souvenirs when they return from global jaunts. Most private hospitals cater to medical tourists from across the world, and this too raises the risk of bugs travelling across continents.

Secondly, the Nipah virus also uncovered the double standards of our society. While nurse Lini Puthussery, who died after treating the first patient diagnosed with the virus, received kudos and condolences on social media, the ground reality was quite different. The public shunned others from her fraternity, nurses and healthcare workers, with reports of people refusing to travel on the same bus when they suspected them of treating Nipah infected patients. To serve beyond the call of one’s profession, only to be shunned by the very society that one serves, must be truly disheartening for the healthcare fraternity, especially those in direct contact with patients. The only solution to change this mindset is constant communication and awareness campaigns on measures and strategies to prevent such infections.

Thirdly, the scary part is how does one prevent what one cannot recognise? Not much is known about such zoonotic infections. Every mutation in a virus could result in a change in symptoms, making it all the more difficult to detect. While fruit bats and pigs were thought to be the source for the Nipah virus which struck Kerala, later reports debunked this theory. Epidemiologists across the world are blaming man’s unfettered encroachment on tropical forests into agricultural lands for the virus crossing species from tropical fruit bats to humans. The worry is that if the virus mutates enough to enable it to be transmitted from human to human,we will have a pandemic to deal with. Thus, while Fortis and Seven Hills are a warning to hospitals to be financially prudent, the Nipah virus infection is a red flag to plug the gaps on the infection control side.

Viveka Roychowdhury
Editor

[email protected]

 

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